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Advanced Treatment for Liver Cancer
Dr. Pavan Khanna discusses the interventional radiology program at St. Joseph's Medical Center.
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Learn more about Pavan Khanna, MD
Pavan Khanna, MD
Pavan Khanna, MD is a board certified radiologist in Stockton, California. He is affiliated with St. Joseph's Medical Center.Learn more about Pavan Khanna, MD
Transcription:
Advanced Treatment for Liver Cancer
Bill Klaproth (Host): So, when it comes to surgery, smaller is better. And that brings us to interventional radiology which can precisely target therapy as opposed to open surgery. So, let’s learn more about interventional radiology at St. Joseph’s with Dr. Pavan Khanna, the Medical Director of Interventional Radiology at Dignity Health’s St. Josephs Medical Center. Dr. Khanna, thanks for your time today. so, how does interventional radiology work?
Pavan Khanna, MD (Guest): Hi Bill. Thanks for having me. So, interventional radiology is a pretty unique specialty in that we are able to perform minimally invasive procedures using imaging guidance. We can actually perform everything from the simple procedures or what we consider simple or the biopsies and drainages of fluid collection all the way to treating and removing blood clots from the lungs and legs, we treat compression fracture in the spine whether they are related to osteoporosis, trauma or cancer. We can also perform minimally invasive treatments of cancer particularly in the liver, kidney and bone. And what we are seeing is actually similar response rates to surgical procedures for those indications.
And we perform procedures all the way up to those life threatening ones where people have bleeding arising from arteries and veins, anywhere in the chest, abdomen, pelvis, extremities you name it. and we are able to perform these minimally invasive treatments going through the arteries and veins and stopping them from the inside.
In total, we do about probably I would say about 75 or so unique different procedures and again, some of these required open surgery and now we are able to do these in a minimally invasive manner and able to reduce complication rates and recovery times for most patients.
Host: That is a wide range of procedures you said 75, holy cow. So, let’s stick with liver cancer since you mentioned that. Tell us about the specialized treatment for that with interventional radiology.
Dr. Khanna: Sure. So, what we are seeing actually is live cancer is actually on the rise and we are able to treat not only primary liver cancer but secondary liver cancer that arises in a different site in the body and travels to the liver. One of the procedures we’ve been doing for the last couple of years is a procedure called radioembolization and that actually entails us actually just going through an artery in the groin, so it’s a little needle poke in there through that needle, we are actually able to guide tiny little wires and catheters up to the arteries in the liver, similar to if a patient has had an angiogram of the heart, same kind of concept but we are actually focusing on the liver.
And so, what we do is most of the tumors in the liver are actually supplied by arteries and about two thirds of the liver, the organ itself, is actually supplied by a vein. So, it’s a very unique organ in the body. But what we see is that because those tumors are supplied by the arteries and not the vein; we are able to deliver high doses of either chemotherapy in which we would call it a chemoembolization or little beads that have radiation in them directly into the artery supplying the tumor. And that’s what we call radioembolization.
And we’ve been doing that like I said for a couple or years now. We actually do more cases here at St. Joseph’s than any other hospital in the state of California. And we are probably in the top three for all hospitals including academic and community centers on the entire west coast. So, we’ve had great success rates, patients tolerate the procedure well and we are getting great results so far.
Host: So. with this technology, you can target precisely where the treatment needs to be. Is that right? You were talking about liver cancer. You can find that vein or that problem area is and target it precisely. Is that right?
Dr. Khanna: Absolutely. And so when we are doing these procedures, we’re injecting contrast dye into the arteries and that enables us to see via x-ray the tumor sort of light up when we are in that artery supplying it directly. And once we get into that artery, like I said, we can deliver little beads that have either chemotherapy in them or radiation in them. And so this is something – a lot of patients who present to us either are not great surgical candidates or not good candidates for liver transplant and so what we are able to do is actually provide them a really great treatment option and potentially either have to avoid surgery or at least keep their disease under control while they are waiting for another definitive treatment option.
Host: Yeah, and that is really important. So, you were talking about radioembolization. I imagine one of the benefits of what you are doing now with this is that patients no longer have to leave the community right, for specialized cancer treatments. They can stay right there. That’s probably one of the reasons you are doing more cases than even the university hospitals.
Dr. Khanna: Absolutely. And so, the interesting thing is that a lot of these minimally invasive treatment options for the liver, previously we really done at most of the academic and university centers. And so, being in northern California, we have several surrounding us but my goal was to bring that procedure and those technologies to our community so that like you said, the patients would not have to leave the community. And so with that, we are able to deliver really comprehensive cancer care here at St. Josephs in conjunction with our medical, surgical and radiation oncologists.
Host: So important and such a great benefit to the community. So, Dr. Khanna, I’m thinking a lot of people may have never even heard of interventional radiology, so if you could wrap this up for us so we all have a common understanding of this especially for the person listening right now. How would you describe interventional radiology, so we all have a basic common understanding of what this is?
Dr. Khanna: Yeah, that’s a great question. Because a lot of people don’t really know what interventional radiology is. We sort of started as a subgroup of diagnostic radiology where we started doing interventions but now we’ve kind of taken on a totally different role and like I said, as I mentioned, we are doing all these different kinds of treatments, even cancer treatments and so, it really comes down to we are minimally invasive surgical specialty where we are able to offer these treatments with really an incision no greater than about half an inch in the body. And we are able to deliver these treatments and provide options for patients that like I said previously, required open surgery. In doing so, we are able to reduce complication rates and recovery times. And so, to sum it up, I would say, what we do procedures using imaging guidance that we are able to cover pretty much from the neck all the way down to the toes and do all different types of procedures involving different organs of the body.
Host: What an exciting advancement in technology. Dr. Khanna thank you so much for explaining this to us today and for more information on interventional radiology, please visit www.stjosephscares.org. And if you liked what you’ve heard, please share it on your social channels and be sure to check out our full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I’m Bill Klaproth. Thanks for listening.
Advanced Treatment for Liver Cancer
Bill Klaproth (Host): So, when it comes to surgery, smaller is better. And that brings us to interventional radiology which can precisely target therapy as opposed to open surgery. So, let’s learn more about interventional radiology at St. Joseph’s with Dr. Pavan Khanna, the Medical Director of Interventional Radiology at Dignity Health’s St. Josephs Medical Center. Dr. Khanna, thanks for your time today. so, how does interventional radiology work?
Pavan Khanna, MD (Guest): Hi Bill. Thanks for having me. So, interventional radiology is a pretty unique specialty in that we are able to perform minimally invasive procedures using imaging guidance. We can actually perform everything from the simple procedures or what we consider simple or the biopsies and drainages of fluid collection all the way to treating and removing blood clots from the lungs and legs, we treat compression fracture in the spine whether they are related to osteoporosis, trauma or cancer. We can also perform minimally invasive treatments of cancer particularly in the liver, kidney and bone. And what we are seeing is actually similar response rates to surgical procedures for those indications.
And we perform procedures all the way up to those life threatening ones where people have bleeding arising from arteries and veins, anywhere in the chest, abdomen, pelvis, extremities you name it. and we are able to perform these minimally invasive treatments going through the arteries and veins and stopping them from the inside.
In total, we do about probably I would say about 75 or so unique different procedures and again, some of these required open surgery and now we are able to do these in a minimally invasive manner and able to reduce complication rates and recovery times for most patients.
Host: That is a wide range of procedures you said 75, holy cow. So, let’s stick with liver cancer since you mentioned that. Tell us about the specialized treatment for that with interventional radiology.
Dr. Khanna: Sure. So, what we are seeing actually is live cancer is actually on the rise and we are able to treat not only primary liver cancer but secondary liver cancer that arises in a different site in the body and travels to the liver. One of the procedures we’ve been doing for the last couple of years is a procedure called radioembolization and that actually entails us actually just going through an artery in the groin, so it’s a little needle poke in there through that needle, we are actually able to guide tiny little wires and catheters up to the arteries in the liver, similar to if a patient has had an angiogram of the heart, same kind of concept but we are actually focusing on the liver.
And so, what we do is most of the tumors in the liver are actually supplied by arteries and about two thirds of the liver, the organ itself, is actually supplied by a vein. So, it’s a very unique organ in the body. But what we see is that because those tumors are supplied by the arteries and not the vein; we are able to deliver high doses of either chemotherapy in which we would call it a chemoembolization or little beads that have radiation in them directly into the artery supplying the tumor. And that’s what we call radioembolization.
And we’ve been doing that like I said for a couple or years now. We actually do more cases here at St. Joseph’s than any other hospital in the state of California. And we are probably in the top three for all hospitals including academic and community centers on the entire west coast. So, we’ve had great success rates, patients tolerate the procedure well and we are getting great results so far.
Host: So. with this technology, you can target precisely where the treatment needs to be. Is that right? You were talking about liver cancer. You can find that vein or that problem area is and target it precisely. Is that right?
Dr. Khanna: Absolutely. And so when we are doing these procedures, we’re injecting contrast dye into the arteries and that enables us to see via x-ray the tumor sort of light up when we are in that artery supplying it directly. And once we get into that artery, like I said, we can deliver little beads that have either chemotherapy in them or radiation in them. And so this is something – a lot of patients who present to us either are not great surgical candidates or not good candidates for liver transplant and so what we are able to do is actually provide them a really great treatment option and potentially either have to avoid surgery or at least keep their disease under control while they are waiting for another definitive treatment option.
Host: Yeah, and that is really important. So, you were talking about radioembolization. I imagine one of the benefits of what you are doing now with this is that patients no longer have to leave the community right, for specialized cancer treatments. They can stay right there. That’s probably one of the reasons you are doing more cases than even the university hospitals.
Dr. Khanna: Absolutely. And so, the interesting thing is that a lot of these minimally invasive treatment options for the liver, previously we really done at most of the academic and university centers. And so, being in northern California, we have several surrounding us but my goal was to bring that procedure and those technologies to our community so that like you said, the patients would not have to leave the community. And so with that, we are able to deliver really comprehensive cancer care here at St. Josephs in conjunction with our medical, surgical and radiation oncologists.
Host: So important and such a great benefit to the community. So, Dr. Khanna, I’m thinking a lot of people may have never even heard of interventional radiology, so if you could wrap this up for us so we all have a common understanding of this especially for the person listening right now. How would you describe interventional radiology, so we all have a basic common understanding of what this is?
Dr. Khanna: Yeah, that’s a great question. Because a lot of people don’t really know what interventional radiology is. We sort of started as a subgroup of diagnostic radiology where we started doing interventions but now we’ve kind of taken on a totally different role and like I said, as I mentioned, we are doing all these different kinds of treatments, even cancer treatments and so, it really comes down to we are minimally invasive surgical specialty where we are able to offer these treatments with really an incision no greater than about half an inch in the body. And we are able to deliver these treatments and provide options for patients that like I said previously, required open surgery. In doing so, we are able to reduce complication rates and recovery times. And so, to sum it up, I would say, what we do procedures using imaging guidance that we are able to cover pretty much from the neck all the way down to the toes and do all different types of procedures involving different organs of the body.
Host: What an exciting advancement in technology. Dr. Khanna thank you so much for explaining this to us today and for more information on interventional radiology, please visit www.stjosephscares.org. And if you liked what you’ve heard, please share it on your social channels and be sure to check out our full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I’m Bill Klaproth. Thanks for listening.